The Markle test, also known as the heel-drop test, is a clinical maneuver used to assess for abdominal pain, specifically indicative of peritoneal irritation, and commonly associated with acute appendicitis.
Understanding the Markle Test
How It Works
The Markle test involves the following:
- The patient stands on their toes.
- They are then asked to drop down forcefully onto their heels.
- A positive test is indicated by pain in the right lower quadrant of the abdomen upon impact.
Underlying Mechanism
The jarring motion of the heel drop causes the visceral peritoneum to move, aggravating any inflammation present. This is particularly notable in conditions like appendicitis, where the inflamed appendix irritates the adjacent peritoneum.
Significance in Diagnosis
Differential Diagnosis
The Markle test is not specific to appendicitis. It can indicate irritation of the peritoneum in other conditions. These can include:
- Peritonitis (inflammation of the peritoneum).
- Diverticulitis (inflammation of small pouches in the digestive tract)
- Other inflammatory conditions in the abdominal cavity.
Clinical Application
It's crucial to note that the Markle test is usually just one component of a comprehensive clinical examination, it is often used in conjunction with other diagnostic tests such as:
- Abdominal palpation
- Blood tests
- Imaging studies such as CT scans or ultrasounds
Example of a Positive Markle Test
If a patient presents with right lower quadrant pain that intensifies when they perform the heel-drop maneuver, the Markle test is considered positive. This finding would then need to be interpreted along with other findings to establish a definitive diagnosis.
Summary Table
| Test Name | Description | Positive Result | Potential Conditions |
|---|---|---|---|
| Markle Test | Patient drops forcefully from toes onto their heels. | Pain in the right lower quadrant of the abdomen | Appendicitis, Peritonitis, Diverticulitis |
